Login to Access Video or Poster Abstract: MP10-15
Sources of Funding: None

Introduction

While recurrent disease patterns following radical cystectomy (RC) for urothelial carcinoma (UC) of the urinary bladder have been described, little is known regarding other histologic subtypes of bladder cancer. Herein, we describe recurrence patterns of different histological subtypes {adenocarcinoma (AC), squamous cell carcinoma (SCC), and UC with glandular/squamous metaplasia (UCM)} following RC.

Methods

We retrospectively analyzed patients who underwent RC between 1997-2004 at a Mansoura, Egypt. Patient demographics, tumor pathologic features and recurrence sites were retrieved. The association between recurrence sites and different histopathological features was evaluated.

Results

Of 1,238 RC patients identified, 374 (30%) {181 (48%) UC, 105 (28%) SCC, 35 (9%) AC, and 53 (14%) UCM} had recurrent disease. 180 (48%) had local recurrence, 106 (28%) had distant, and 88 (24%) had both. SCC had the highest local (62%), UC the highest distant (32%), and UCM the highest combined local and distant recurrence rates (30%) (p=0.05). High tumor stage was significantly associated with recurrence, regardless of the site (p=0.006). There were no significant associations between recurrence sites and tumor grade, lymphovascular invasion, lymph node positivity, a history of schistosomiasis infection, gender, and age (p>0.05 for all). The most common site of local recurrence was the pelvis (87%) across all histologic subtypes; for distant recurrence, the most common site (50%) was bone (Table 1). AC recurred the most in bone (62%) and less in the lung (5%), while lung metastasis accounted for 16% of SCC recurrence.

Conclusions

Patterns of disease recurrence vary significantly among different histopathological types and stages of bladder cancer. Tumor grade, lymphovascular invasion, lymph node positivity, schistosomiasis history, gender, and age are not associated with patterns of recurrence following RC for bladder cancer; further study is required to explain recurrence patterns.

Funding

None